anthony
Founder
This is a sufferers view for what the PTSD diagnosis should be. I would suggest it is done in such a way that it covers both trauma and complex trauma in a single diagnosis.
See the following reply for further information -- this first post will contain the completed diagnostic solution.
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A. An event in which one of the following were present:
(1) Directly experiencing or witnessing actual or immediate threat of death, catastrophic injury, or sexual violence.
(2) Direct and frequent exposure, over a prolonged period, to recordings of actual death, catastrophic injury or sexual violence against people, where that exposure is non voluntary or for work purposes.
B. Presence of two (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred:
G. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
H. The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.
Specifiy whether:
With dissociative symptoms: The individual’s symptoms meet the criteria for posttraumatic stress disorder, and in addition, in response to the stressor, the individual experiences persistent or recurrent symptoms of either of the following:
Specify if:
With delayed expression: If the full diagnostic criteria are not met until at least 6 months after the event (although the onset and expression of some symptoms may be immediate).
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See the following reply for further information -- this first post will contain the completed diagnostic solution.
---------------------- Start Diagnosis --------------------------------
A. An event in which one of the following were present:
(1) Directly experiencing or witnessing actual or immediate threat of death, catastrophic injury, or sexual violence.
(2) Direct and frequent exposure, over a prolonged period, to recordings of actual death, catastrophic injury or sexual violence against people, where that exposure is non voluntary or for work purposes.
B. Presence of two (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred:
- Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s) Note: In children older than 6 years, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed.
- Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). Note:In children, there may be frightening dreams without recognizable content.
- Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) Note: In children, trauma-specific reenactment may occur in play.
- Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
- Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
- Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
- Avoidance of or efforts to avoid external stimuli such as places, conversations, activities, objects, and situations that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
- Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).
- Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,” “no one can be trusted,” “The world is completely dangerous,” “My whole nervous system is permanently ruined”).
- Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others.
- Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).
- Markedly diminished interest or participation in significant activities.
- Feelings of detachment or estrangement from others.
- Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).
- Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.
- Reckless or self-destructive behavior.
- Hypervigilance, expressed as heightened sensitivity to potential threats (e.g., fear of motor vehicles following an accident), whether related or unrelated to the traumatic event (e.g., fear of sudden shock causing a heart attack).
- Exaggerated startle response.
- Problems with concentration, such as difficulty remembering daily events or attending to focused tasks (e.g., reading, conversing)
- Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).
- Somatization relating to the traumatic event(s), marked by significant distress or disruption to daily life.
G. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
H. The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.
Specifiy whether:
With dissociative symptoms: The individual’s symptoms meet the criteria for posttraumatic stress disorder, and in addition, in response to the stressor, the individual experiences persistent or recurrent symptoms of either of the following:
- Depersonalization: Persistent or recurrent experiences of feeling detached from, and as if one were an outside observer of, one's mental processes or body (e.g., feeling as though one were in a dream; feeling a sense of unreality of self or body or of time moving slowly).
- Derealization: Persistent or recurent experiences of unreality of surroundings (e.g., the world around the individual is experienced as unreal, dreamlike, distant, or distorted).
- Regulation: Persistent inability to regulate emotion leading to suicidal tendencies, self-mutilation and self-destructive behaviors.
Specify if:
With delayed expression: If the full diagnostic criteria are not met until at least 6 months after the event (although the onset and expression of some symptoms may be immediate).
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